{Ed’s. Note - Full Story atCaribbean Fever} Dr. Velma Scantlebury-White, the nation’s first African American female transplant surgeon and associate director of the Kidney Transplant Program in Delaware at Christiana Care Health System, has performed more than 800 transplants in children and adults.

Scantlebury-White was a transplant surgeon at the University of Pittsburgh School of Medicine from 1988 to 2002. Her research interests include outcomes of organ donations and transplantations in African-Americans, and she was recently honored with the National Kidney Foundation’s Gift of Life Award for her work in transplantation among minorities.

Her hands, once deemed “too small for a surgeon,” have cut and stitched their way through more than 200 living donor kidney transplants, four times as many cadaveric donor transplants, and many other complicated organ transplants.

“Small hands can be better than big hands in surgery, especially when you’re working on kids.”

… Outside the OR, the biggest challenge, she says, is maintaining longevity. The average survival time for a kidney transplant is 10 to 15 years for a living donor kidney transplant and eight years for a transplant from a cadaver organ. “We’re good at controlling acute rejection early on, but we still don’t have a good handle on controlling the chronic destruction that occurs over time.”

Another challenge is finding funds to pay for essential post-transplant drugs. Medicare covers 80 percent of the cost of medications for the first three years after transplantation. Beyond that, as Scantlebury-White bluntly puts it: “You’re on your own, honey! Medicare expects people to get a job and go back to work, but not everybody is able to do that.”

Many of her patients are either uninsured or underinsured. With Medicare co-pays sometimes running as high as $500 to $800 a month, family budgets are strained. Consequently, patients stretch their medications to make them last, kidneys fail, and they return to dialysis. “It’s a medical catch-22,” Scantlebury-White concedes…